HIV and Chagas Disease: An Evaluation of the Use of Real-Time Quantitative Polymerase Chain Reaction to Measure Levels of Trypanosoma cruzi Parasitemia in HIV Patients in Cochabamba, Bolivia
| Autor: | Jules Terle, Melissa J. Reimer-McAtee, Edward Valencia, Jeanne Cabeza, Robert H. Gilman, Caryn Bern, Rosario Castro, Faustino Torrico, Monica J. Pajuelo, Carolina Mejia, Taryn Clark, Daniel Lozano, Meredith Lora |
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| Rok vydání: | 2020 |
| Předmět: |
Chagas disease
Adult Male Bolivia Patients medicine.medical_treatment Trypanosoma cruzi Antibodies Protozoan HIV Infections Parasitemia Quantitative Polymerase Chain Real-Time Polymerase Chain Reaction Parasite load Parasite Load Immune system Cochabamba Virology parasitic diseases Medicine Humans Chagas Disease Microscopy biology business.industry Coinfection HIV Immunosuppression Middle Aged Viral Load biology.organism_classification medicine.disease Trypanocidal Agents CD4 Lymphocyte Count Infectious Diseases Real-time polymerase chain reaction Cross-Sectional Studies Editorial Nitroimidazoles Latent Infection Parasitology Female Trypanosoma cruzi Parasitemia business Viral load |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene |
| ISSN: | 1476-1645 |
| Popis: | This cross-sectional study evaluated epidemiologic characteristics of persons living with HIV (PWH) coinfected with Trypanosoma cruzi in Cochabamba, Bolivia, and estimated T. cruzi parasitemia by real-time quantitative polymerase chain reaction (qPCR) in patients with and without evidence of reactivation by direct microscopy. Thirty-two of the 116 HIV patients evaluated had positive serology for T. cruzi indicative of chronic Chagas disease (27.6%). Sixteen of the 32 (50%) patients with positive serology were positive by quantitative polymerase chain reaction (qPCR), and four of the 32 (12.5%) were positive by direct microscopy. The median parasite load by qPCR in those with CD4+ P = 0.89). There was a significant inverse relationship between the degree of parasitemia estimated by qPCR from blood clot and CD4+ count on the logarithmic scale (rsBC= –0.70, P = 0.007). The correlation between T. cruzi estimated by qPCR+ blood clot and HIV viral load was statistically significant with rsBC = 0.61, P = 0.047. Given the significant mortality of PWH and Chagas reactivation and that 57% of our patients with CD4+ counts 3 showed evidence of reactivation, we propose that screening for chronic Chagas disease be considered in PWH in regions endemic for Chagas disease and in the immigrant populations in nonendemic regions. Additionally, our study showed that PWH with advancing immunosuppression have higher levels of estimated parasitemia measured by qPCR and suggests a role for active surveillance for Chagas reactivation with consideration of treatment with antitrypanosomal therapy until immune reconstitution can be achieved. |
| Databáze: | OpenAIRE |
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